JAMA Surg:氨甲环酸用于大手术出血风险的预防及安全性研究

2021-04-20 MedSci原创 MedSci原创

静脉注射氨甲环酸用于大手术出血风险的预防是安全的,不会导致血栓栓塞事件风险增加

大手术通常会导致患者大量失血,并导致随后贫血和输血需求风险增加。VISION研究称,在40004 名接受非心脏手术的患者中,最常见的导致死亡的并发症是大出血后心肌损伤和感染。氨甲环酸(TXA)是一种抗纤维蛋白溶解剂,广泛用于预防和治疗高纤维蛋白溶解引起的出血。Poeran等研究人员发现,TXA显著减少了大手术失血和相关并发症风险,2012年的临床使用率达11.2%。在众多TXA相关不良事件中,血管闭塞性事件是十分危险的。

近日研究人员考察了静脉注射氨甲环酸的总血栓栓塞事件(TEs)风险。

本次研究为系统综述及荟萃分析研究,收集1976-2020年间相关研究,比较静脉注射TXA或安慰剂治疗后的不良事件。研究的主要终点为血管闭塞事件和死亡率。

总计216个试验,包括125550名患者。TXA组总TEs发生1020例(2.1%),对照组有900例(2.0%)。研究发现静脉注射TXA与静脉血栓形成、肺栓塞、静脉TEs、心肌梗死或缺血、脑梗死或缺血风险(风险差异=0.001)之间没有关联。研究发现,使用TXA后,患者总死亡率和出血死亡率显著降低,但对非出血死亡率无显著影响。此外,在包含血栓病史的患者研究中,没有发现TXA对血管闭塞事件的影响。比较样本量小于或等于99(风险差异=0.004)、100至999(风险差异=0.004)和大于或等于1000(风险差异=-0.001)研究之间的结果差异,未发现样本量对TXA-总TEs风险的影响。TXA治疗剂量与静脉TEs风险无关(风险差异=-0.005)。

研究认为,静脉注射氨甲环酸用于大手术出血风险的预防是安全的,不会导致血栓栓塞事件风险增加

原始出处:

Isabel Taeuber et al. Association of Intravenous Tranexamic Acid With Thromboembolic Events and Mortality A Systematic Review, Meta-analysis, and Meta-regression.JAMA Surg. April 14, 2021.

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (5)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1721999, encodeId=205d1e21999b3, content=<a href='/topic/show?id=b73f43e1224' target=_blank style='color:#2F92EE;'>#大手术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=43712, encryptionId=b73f43e1224, topicName=大手术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ecc933126179, createdName=Smile2691, createdTime=Fri Sep 17 10:09:18 CST 2021, time=2021-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=958994, encodeId=26e795899488, content=优秀, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210420/7c5c53fbde0e4181bbfe9fa9330b16e1/aaa7301f2e7f488faff67f9f31895373.jpg, createdBy=4d9f5480726, createdName=huhuanyi, createdTime=Wed Apr 21 10:03:52 CST 2021, time=2021-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=958976, encodeId=af4e9589e6d7, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45ef1467049, createdName=38737852, createdTime=Wed Apr 21 08:54:12 CST 2021, time=2021-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036581, encodeId=9b6c1036581ba, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Tue Apr 20 23:09:18 CST 2021, time=2021-04-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=958879, encodeId=01f49588e90e, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b5f55457177, createdName=ms6000001533126906, createdTime=Tue Apr 20 21:27:08 CST 2021, time=2021-04-20, status=1, ipAttribution=)]
  2. [GetPortalCommentsPageByObjectIdResponse(id=1721999, encodeId=205d1e21999b3, content=<a href='/topic/show?id=b73f43e1224' target=_blank style='color:#2F92EE;'>#大手术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=43712, encryptionId=b73f43e1224, topicName=大手术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ecc933126179, createdName=Smile2691, createdTime=Fri Sep 17 10:09:18 CST 2021, time=2021-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=958994, encodeId=26e795899488, content=优秀, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210420/7c5c53fbde0e4181bbfe9fa9330b16e1/aaa7301f2e7f488faff67f9f31895373.jpg, createdBy=4d9f5480726, createdName=huhuanyi, createdTime=Wed Apr 21 10:03:52 CST 2021, time=2021-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=958976, encodeId=af4e9589e6d7, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45ef1467049, createdName=38737852, createdTime=Wed Apr 21 08:54:12 CST 2021, time=2021-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036581, encodeId=9b6c1036581ba, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Tue Apr 20 23:09:18 CST 2021, time=2021-04-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=958879, encodeId=01f49588e90e, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b5f55457177, createdName=ms6000001533126906, createdTime=Tue Apr 20 21:27:08 CST 2021, time=2021-04-20, status=1, ipAttribution=)]
    2021-04-21 huhuanyi

    优秀

    0

  3. [GetPortalCommentsPageByObjectIdResponse(id=1721999, encodeId=205d1e21999b3, content=<a href='/topic/show?id=b73f43e1224' target=_blank style='color:#2F92EE;'>#大手术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=43712, encryptionId=b73f43e1224, topicName=大手术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ecc933126179, createdName=Smile2691, createdTime=Fri Sep 17 10:09:18 CST 2021, time=2021-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=958994, encodeId=26e795899488, content=优秀, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210420/7c5c53fbde0e4181bbfe9fa9330b16e1/aaa7301f2e7f488faff67f9f31895373.jpg, createdBy=4d9f5480726, createdName=huhuanyi, createdTime=Wed Apr 21 10:03:52 CST 2021, time=2021-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=958976, encodeId=af4e9589e6d7, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45ef1467049, createdName=38737852, createdTime=Wed Apr 21 08:54:12 CST 2021, time=2021-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036581, encodeId=9b6c1036581ba, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Tue Apr 20 23:09:18 CST 2021, time=2021-04-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=958879, encodeId=01f49588e90e, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b5f55457177, createdName=ms6000001533126906, createdTime=Tue Apr 20 21:27:08 CST 2021, time=2021-04-20, status=1, ipAttribution=)]
    2021-04-21 38737852

    0

  4. [GetPortalCommentsPageByObjectIdResponse(id=1721999, encodeId=205d1e21999b3, content=<a href='/topic/show?id=b73f43e1224' target=_blank style='color:#2F92EE;'>#大手术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=43712, encryptionId=b73f43e1224, topicName=大手术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ecc933126179, createdName=Smile2691, createdTime=Fri Sep 17 10:09:18 CST 2021, time=2021-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=958994, encodeId=26e795899488, content=优秀, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210420/7c5c53fbde0e4181bbfe9fa9330b16e1/aaa7301f2e7f488faff67f9f31895373.jpg, createdBy=4d9f5480726, createdName=huhuanyi, createdTime=Wed Apr 21 10:03:52 CST 2021, time=2021-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=958976, encodeId=af4e9589e6d7, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45ef1467049, createdName=38737852, createdTime=Wed Apr 21 08:54:12 CST 2021, time=2021-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036581, encodeId=9b6c1036581ba, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Tue Apr 20 23:09:18 CST 2021, time=2021-04-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=958879, encodeId=01f49588e90e, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b5f55457177, createdName=ms6000001533126906, createdTime=Tue Apr 20 21:27:08 CST 2021, time=2021-04-20, status=1, ipAttribution=)]
    2021-04-20 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1721999, encodeId=205d1e21999b3, content=<a href='/topic/show?id=b73f43e1224' target=_blank style='color:#2F92EE;'>#大手术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=43712, encryptionId=b73f43e1224, topicName=大手术)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ecc933126179, createdName=Smile2691, createdTime=Fri Sep 17 10:09:18 CST 2021, time=2021-09-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=958994, encodeId=26e795899488, content=优秀, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210420/7c5c53fbde0e4181bbfe9fa9330b16e1/aaa7301f2e7f488faff67f9f31895373.jpg, createdBy=4d9f5480726, createdName=huhuanyi, createdTime=Wed Apr 21 10:03:52 CST 2021, time=2021-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=958976, encodeId=af4e9589e6d7, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=45ef1467049, createdName=38737852, createdTime=Wed Apr 21 08:54:12 CST 2021, time=2021-04-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1036581, encodeId=9b6c1036581ba, content=顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=旺医, createdTime=Tue Apr 20 23:09:18 CST 2021, time=2021-04-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=958879, encodeId=01f49588e90e, content=好, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b5f55457177, createdName=ms6000001533126906, createdTime=Tue Apr 20 21:27:08 CST 2021, time=2021-04-20, status=1, ipAttribution=)]
    2021-04-20 ms6000001533126906

    0

相关资讯

EClinical Medicine:COVID-19可导致不同程度的血栓栓塞,且与较高的死亡风险相关!

曾有研究显示,COVID-19与凝血功能障碍有关,COVID-19患者会发生不同程度的血栓栓塞。一些研究指出,COVID-19患者的血栓栓塞发生率为20%到30%,而另一些研究报告则高达40%到70%

Blood:III试验:不同方案治疗的骨髓瘤患者的血栓形成情况

新确诊的接受治疗的骨髓瘤患者的VTE风险较高,通过IMWG指导的血栓预防仅可轻度降低该风险。 沙利度胺和来那度胺治疗的静脉血栓栓塞风险相同;在本试验中,VTE与PFS或OS 降低无关。

J Thromb Haemost:抗磷脂抗体阳性的静脉或动脉血栓栓塞患者复发性血栓形成

与aPL阳性的VTE患者相比,aPL阳性的ATE患者可能受益于不同的抗栓方法。为了确定最佳的抗血栓形成策略,必须对具有明确定义的aPL阳性的TE队列进行前瞻性研究。

Blood:免疫检查点抑制剂治疗的癌症患者的血栓栓塞风险增加!

目前,与免疫检查点抑制剂相关的静脉和动脉血栓栓塞(VTE/ATE)的风险尚未完全明确,在癌症患者中评估这类药物的临床试验并未提供相关信息。

反常栓塞,你能想起哪些疾病?

反常栓塞指静脉系统或右心的栓子通过右向左的分流通道,从右心系统进入左心系统,从而引起相应部位的体循环栓塞。反常性栓塞有4项诊断标准: